06 March 2007

U.S. system failing NC woman

Bravo to the New York Times for beginning to do a better job covering healthcare. These stories write themselves — they're David vs Goliath; they've got pathos; this is an important philosophical issue, a vital matter of how values are a matter of life and death in the material world; they've got storylines that average readers can relate to. I predict that some paper will in the next couple years pull together a series that will win a Pulitzer for exposing and explaining the healthcare fiasco.

Part of the story will be how the for-profit U.S. medical system with its powerful lobby proved too successful for its own good — like a killer virus version of the auto industry. By insulating themselves from real market forces and by being too greedy, they've "sh&%^ in their own messkit," as Bob Pfohman would say.

The free-market competition that was supposed to bring down costs for consumers instead went to work to bring down costs for the true consumer in our system. That would be the insurance companies. Patients are an afterthought — a product, in a way. The insurance companies began to compete for the least-cost product — the healthiest populations to insure. They excluded higher cost products from the scheme. But by doing so, their administrative costs went up, and the risk pool shrank. Once begun, this paradigm was like a truck without brakes on a mountain decline.

At first it was wiping out only the weakest links. No longer. It's now smashing and damaging solidly middle-class families — families who had just a dozen years ago bought into the lie that forcing those out-of-control for-profit trucks onto escape ramps was just too dangerous, too hard on the economy, and that the government couldn't be trusted.

OK, OK. Enough with the metaphor.

Here's the Times story, about a Realtor making $60,000 a year who couldn't get get insurance for less than $27,000 a year because she'd had cancer.
Ms. Readling said she often woke up at night, terrified of the cost of getting sick without insurance.

“Anything that goes wrong with my health could destroy me financially,” Ms. Readling said. “I could be ruined.”

She said she had never voluntarily allowed her insurance to lapse and could not understand why she was being blackballed.

“What did I do wrong?” Ms. Read-ling asked. “Why am I being punished? I just don’t understand how I could have fallen through this horrible, horrible crack.”

Knowing her health benefits from her prior job would expire in January 2006, she began shopping for a new policy in May 2005. But in June 2005, she learned she had cancer.

“At that point,” Ms. Readling said, “I called everybody I could think of, begging for help. But no insurer would touch me.”

Barbara Morales Burke, the chief deputy insurance commissioner of North Carolina, said state law did not guarantee the availability of health insurance for individuals. “Most insurers decline to issue policies to those individuals whom they deem to be too risky because of their medical history,” Ms. Morales Burke said.

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